Whooping cough in general practice

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.333.7560.159 (Published 20 July 2006) Cite this as: BMJ 2006;333:159
  1. Chris Butler (butlercc@cf.ac.uk), professor of primary care medicine,
  2. Nick Francis, MRC fellow, Cardiff University,
  3. Geert-Jan Dinant, professor of clinical research in general practice
  1. School of Medicine, Department of General Practice, Cardiff University, Cardiff CF14 4XN
  2. School of Medicine, Department of General Practice, Cardiff University, Cardiff CF14 4XN
  3. Department of General Practice and Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands

    Prognosis matters more than diagnosis

    General practitioners seldom diagnose, or even consider, pertussis in older children who present with ongoing cough as a main symptom. Should this change in the light of new information in a paper by Harnden and colleagues in this week's issue (p 174)?1 They found that nearly 40% of a cohort of children aged 5-16 years presenting in UK general practice with a cough lasting 14 days or more had serological evidence of recent pertussis infection. This figure is perhaps even double that expected from previous research.23

    The authors conclude that GPs should make a “secure diagnosis of whooping cough” to prevent inappropriate worry and treatment and demand for further tests. GPs are likely to follow this disease focused approach only if they feel that diagnosing whooping cough more often is both feasible and clinically important. The problem is that most of the currently available approaches to laboratory diagnosis either do not perform adequately …

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